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ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 1  |  Page : 42-47

Evaluation of the analgesic effect of caudal dexamethasone combined with bupivacaine in hypospadias repair surgery


Department of Anesthesia and Intensive Care, Faculty of Medicine, El-Minia University, Minia, Egypt

Correspondence Address:
Ahmed Z Mohamed
21 Sarofim Street, Minia, Minia Governorate
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2356-9115.184077

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Background Caudal analgesia is the most popular regional technique in infants and children for the infraumbilical surgeries. Its main disadvantage though is its short duration. The aim of this prospective, randomized, double-blind study was to examine the effect of dexamethasone (when added to the caudal bupivacaine) on the duration of postoperative analgesia and the intensity of postoperative pain during hypospadias repair surgeries. Patients and methods A total of 70 patients aged 2–5 years with American Society of Anesthesiologists (ASA) physical status classification I or II were randomly divided into two equal groups in a double-blinded manner. The first group (group B) (n = 35) received caudal analgesia with 0.25% bupivacaine 1 ml/kg, whereas the second group (group D) (n = 35) received caudal analgesia with bupivacaine 0.25% 1 ml/kg plus 0.1 mg/kg dexamethasone. After inhalational induction with sevoflurane and tracheal intubation, patients were turned to lateral position and were given the caudal analgesia. After the end of surgery, postoperative pain score was measured by using Children's and Infants' Postoperative Pain Score (CHIPPS). The primary outcome of this study was the duration of the postoperative caudal analgesia. Severity of postoperative pain, number of rescue analgesic doses, residual motor block, and side effects like nausea and vomiting (secondary outcomes) were monitored. Results The second group (group D) showed significantly longer duration of postoperative analgesia when compared with the first (group B) group. CHIPPS was less in group D compared with group B at 3, 6, 12, and 24 h. Number of rescue analgesic doses of was less in group B than in group D. Modified Bromage scale score were comparable in both groups. Conclusion Adding dexamethasone 0.1 mg/kg to the caudal bupivacaine significantly prolonged the duration of postoperative caudal analgesia and decreased the intensity of postoperative pain during hypospadias repair surgery.


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